One rule of the Affordable Care Act that has been delayed for a year limits the amount that a patient has to spend on so-called "out-of-pocket" costs -- mainly deductibles and co-payments.

But it hasn't been delayed for everyone. Those who buy their own coverage are still protected; the delay affects some employer plans.

The Obama administration agreed to delay the rule for employer plans that use different vendors for their medical and drug coverage, after some companies said they couldn't get their vendors' computer programs to work together without more time.

In his Saturday address, President Obama complained that critics of the Affordable Care Act are trying to "gum up the works" to keep the health law from succeeding as implementation of its major features nears on Jan. 1, as Politico reports.

The Oct. 1 launch of the new health insurance exchanges is now less than two months away, and people are starting to pay attention to the changes these new marketplaces may bring to the nation's health care system.


It appears that virtually all counties in the state will receive "navigators" to help their uninsured residents learn how to get coverage under the Affordable Care Act except the one county that needs help most: Miami-Dade.

With more than 30 percent of its under-65 population lacking health insurance, Miami-Dade is not among the counties listed as a specific target by organizations who received Navigator Grants. On Thursday,  Kathleen Sebelius, secretary of the Department of Health and Human Services, announced $7.8 million in grants for Florida.

Scott Keeler / Tampa Bay Times

With Congress on a five-week recess, members are rallying the troops around the state. And the troops are responding. As the South Florida Sun-Sentinel reports, U.S. Rep. Debbie Wasserman Schultz introduced Leslie Sheffield of Fort Lauderdale, a cancer survivor who cares for her 92-year-old mother. Sheffield told a crowd that she and her husband both got sizeable rebate checks on their health insurance this year because of the health law. Wasserman Schultz is a Democrat from Weston. 

Health and Human Services Secretary Kathleen Sebelius was on the University of South Florida Tampa campus Thursday afternoon to hand out $7.8 million in grants to help Floridians with the Affordable Care Act. 

The money will be given to eight organizations around the state to hire staff to help consumers enroll in a health insurance plan. Starting Jan. 1, almost all Americans will be required to buy health insurance under the ACA.

Florida Insurance Commissioner Kevin McCarty says there's no need for the state to regulate health premiums because the Affordable Care Act has a rule that keeps them under control. 

In a discussion with the Orlando Sentinel editorial board, McCarty said the ACA contains a "self-regulator" that limits the amount of the premium that companies can keep for administrative expenses and profits. If insurers spend too little of the premium on health care, he said, they have to return it to the customers who overpaid -- individuals and employers.

Health policy consultant Paul Gionfriddo of Lake Worth writes this week in his blog Our Health Policy Matters a new chapter on an earlier subject:  Why the Affordable Care Act will not be repealed by 2016 no matter how many votes the House takes on it, and despite threats to shut down the government.

It turns out that a good many constituencies will have much to lose and will figure that out quickly, he says.

Demystifying Obamacare

Aug 13, 2013

It's the law of the land, and by Jan. 1, 2014, most Americans will be required to have some form of health insurance under the Affordable Care Act.

Yet, polls show many still are confused about the law and its implementation.

We spoke with Carol Gentry, founder and editor of Health News Florida, a subsidiary of WUSF Public Media in Tampa, for some basics about the ACA or Obamacare - and issues specific to Florida.

First Coast Connect: What should people know about the new insurance exchanges that will be online this fall?

Senate President Don Gaetz sent a letter in June to federal health officials asking for flexibility in designing a plan to cover the working poor under the Affordable Care Act that would not involve Medicaid.

There may be a way for 1 million below-poverty-level uninsured Floridians to gain access to health coverage, even though the state legislature voted against Medicaid expansion.

The Florida Center for Fiscal and Economic Policy has released an issue brief that says the Florida Office of Insurance Regulation is trying to mislead Floridians about the likely impact of the Affordable Care Act on insurance rates.

In a video posted by the Florida Times-Union, Florida Blue CEO Pat Geraghty explains why it  would be good for Florida business if state officials accepted federal dollars for Medicaid expansion. Geraghty also described how Florida Blue is planning to serve more customers once Obamacare comes to Florida by creating partnerships and becoming a health care company, not just an insurance provider.


In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, Democratic members of Congress from Florida accuse the state of relinquishing power over health insurance rates to the federal government -- which lacks enforcement authority.

As fitness expert and personal trainer Marilynn Preston relaxed during a pedicure, she listened to the nail technician lament her confusion about the Affordable Care Act. In a column in the Sarasota Herald-Tribune, Peterson explains how she eased the woman’s fears with facts about the law. 

Associated Press

Members of the all-Republican Florida Cabinet -- Gov. Rick Scott, Attorney General Pam Bondi, Agriculture Commissioner Adam Putnam and Chief Financial Officer Jeff Atwater -- have approved disclosure forms that insurance companies will need to send out to policyholders if their premiums will be affected by the federal Affordable Care Act, the Times/Herald Tallahassee Bureau reports.

Lottie Watts / WUSF

We asked our readers to tell us what they thought was confusing about the Affordable Care Act, and you called, e-mailed and Facebooked us with questions. On Florida Matters, WUSF’s Craig Kopp sits down with attorney Linda Fleming of Carlton Fields; Julian Lago, the regional vice president of the National Association of Health Underwriters, and Health News Florida Editor Carol Gentry to help answer some of those questions. 

To listen to the complete show, visit the Florida Matters website

Chris Zuppa / Tampa Bay Times

With Congress on a five-week break, House Republicans left Washington bearing a playbook for themselves and talking points for business owners who may want to speak at public forums on the Affordable Care Act, the Tampa Bay Times reports.  Democrats say they’re prepared to go toe-to-toe defending the law. 

M. Spencer Green / AP

Florida Blue, the state’s largest insurer, has an inside track to a potentially lucrative market by entering a partnership with Spanish-language network Univision, Kaiser Health News and the Miami Herald report.


Wayne Ezell, a member of the Florida Times-Union editorial board, writes that Sen. Marco Rubio is “maniacal” when talking about the Affordable Care Act.  Ezell cites PolitiFact’s “pants on fire” rating for Rubio’s inaccuracies.

This month, Democrats say, they will won't sit out the summer Congressional recess. They're planning to show up at Town Hall-style meetings sponsored by conservatives to present an alternative view.

In the past, Florida's August meetings have been dominated by Republicans and the Tea Party, denouncing Obamacare. It had an effect in polls, turning the public against the law even as most of its main features  -- when polled separately -- drew approval.

On Wednesday, White House officials pointed out several ways that Floridians will benefit from Obamacare as part of an effort to convince the Florida Legislature to accept federal money to expand Medicaid coverage, the Orlando Sentinel reports.

Two big changes are coming to the individual market, where consumers pay their own way without help from employers. 

The first: Companies can no longer screen out customers who may have health risks, or exclude coverage for certain conditions or body parts.

The second follows from the first: Premiums will go up sharply for those who buy their own policies, about 30 to 40 percent.


About 45,000 low-income working parents in Florida will lose their Medicaid coverage at the end of this year and become uninsured unless they quit their jobs, a coalition of children's advocacy groups says.

KidsWell Florida says this is the surprising and unintended result of a change in the income-calculation system for Medicaid combined with the Florida Legislature's refusal to expand the insurance program for the poor under the Affordable Care Act.

Lottie Watts / WUSF

We asked for readers' questions about the Affordable Care Act, and they responded. They called, emailed and left notes on our Facebook page.

Health News Florida then invited two experts -- an attorney who specializes in health law and a past president of the Florida Association of Health Underwriters -- to help us answer the questions. They will be at our radio recording studio at WUSF Public Media, on the campus of the University of South Florida in Tampa, this morning. 

Along with two other Tea Party favorites, U.S. Sen. Marco Rubio declared on Tuesday that Congress needs to kill Obamacare by taking away all funds to implement it, even if it means a government shutdown as of Sept. 30. The vote comes up shortly after Congress’ five-week recess that begins Friday and lasts through Labor Day.

Insurance Commissioner Kevin McCarty is holding a public hearing today to discuss next year's health insurance rates, which are expected to climb sharply in the individual-purchase market. The public hearing is being televised and live-streamed by The Florida Channel today at 1 p.m., according to a release from the Office of Insurance Regulation.

Only a small fraction of Floridians are in the individual market.  Most insured Floridians -- aside from the millions enrolled in Medicare or Medicaid -- are covered by their employers as a large group (more than 50). 

Phil Galewitz, Kaiser Health News

All over Florida, volunteers and staffers with the nonprofit Enroll America went knocking on doors Saturday, looking for uninsured people so they could tell them about the opportunities for coverage coming this fall.

But in some areas, the "Get Covered, America!" campaign was hampered by out-of-date information from the last census. Some volunteers and staffers found that more often than not, the uninsured people no longer lived at that address.

Since the Affordable Care Act was signed, most state governments have made the most of the federal grants flowing from Washington for health-system reform. Not Florida.

State agencies in Tallahassee have either not competed for grants or, on occasion, have won them but then given the money back.  The latest: a $2.3 million grant for a toll-free consumer health information line. A Florida agency won it, records show, then decided not to take the money.

Gerd Altmann

When it comes to the Affordable Care Act, there's a ton of confusion. At Health News Florida, we're here to help you get the answers you need.

We'd like to get your questions for an upcoming Florida Matters, WUSF's weekly public affairs show.